343623561-5-14-2020-03-CC-SDLA-BPLKH6-20200514075439

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343623561
Report Date: 05/13/2020
Date Signed: 05/14/2020 07:54:45 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME:	SACRAMENTO MONTESSORI SCHOOL		FACILITY NUMBER:	343623561
ADMINISTRATOR:	ROOSTAEYAN, ROBABEH MINA		FACILITY TYPE:	830
ADDRESS:	1111 D STREET		TELEPHONE:	(916) 949-5347
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95814
CAPACITY:	62	CENSUS: 0	DATE:	05/13/2020
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Dalia Chavez, RC Chavez, and Linda Ramos		TIME COMPLETED:	12:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Application Specialist (AS) Seychelle De Luca met with Applicants Dalia Chavez, RC Chavez, and Linda Ramos for the purpose of an announced prelicensing tele-inspection (due to COVID-19). Applicants requests an infant license to serve 30 infants from six weeks to 18 months and 32 toddlers from age 18 months to 33 months under a Toddler Option Program. The program will operate Monday through Friday from 6:30 AM to 6:00 PM. Applicants acknowledge that the following documents must be posted at all times: License, Emergency Disaster Plan, Personal Rights, Parents' Rights Poster, car seat law, menus, and daily schedule. AS discussed the forms that must be in each child's and each staff member's file. Applicants stated the Needs and Services Plans will be kept in the infant classroom, and Applicants acknowledges these plans must be updated quarterly. Parents will provide milk. Facility will provide baby food for infants and snacks and meals for toddlers. INDOOR ACTIVITY SPACE: The facility has one infant classroom and one toddler classroom. AS observed a sufficient amount of equipment, toys, tables, chairs, cubbies, and sleeping mats for toddlers. AS observed a changing table that is within arm's reach of a sink. The napping area is located in the infant classroom and is separated from the activity area with a half wall that is four feet tall. There is a first aid kit and medications will be stored in the infant classroom. AS observed cleaning disinfectants are appropriately stored and inaccessible to children. Applicants stated there are no poisons or firearms on the premises. Applicants stated a water pitcher and cups will be available in both classrooms. AS observed a functional carbon monoxide detector. Applicants stated they will use an electronic sign-in/sign-out system. Report continues on 809-C.

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Seychelle De Luca	TELEPHONE: (916) 217-4316
LICENSING EVALUATOR SIGNATURE:	DATE: 05/13/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2020

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: SACRAMENTO MONTESSORI SCHOOL	FACILITY NUMBER: 343623561
	VISIT DATE: 05/13/2020

NARRATIVE

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Applicants measured the two classrooms, and AS walked Applicants through the measuring process. The classrooms contain a total of 2439.13 square feet, which will accommodate Applicants' request for 62 children. There are three toilets, two potty chairs, and seven sinks for the children, and a separate private restroom for the staff. Individual measurements are recorded on the Capacity Worksheet (LIC 9024). Children who become ill during the day will be isolated in the office and will use the staff restroom, if necessary.

OUTDOOR ACTIVITY SPACE:
There are two outdoor areas for infants and and two outdoor areas for toddlers on the property. These outdoor spaces are separated from the preschool space by a wooden fence. The outdoor play area is fenced with an iron fence that is at least four feet tall. AS observed a sufficient amount of equipment and toys. There are no bodies of water on the premises. There is shade supplied by trees and overhangs. Applicants stated a water pitcher and cups will be available.

Applicants measured the outdoor space, and AS walked Applicants through the measuring process. The outdoor play area contains a total of 2884.687 square feet, which will not accommodate Applicants' request for 62 children. Individual measurements are recorded on the Capacity Worksheet (LIC 9024).

The facility's Plan of Operation is located in the facility file. Incidental Medical Services and a Plan of Operation is located in the facility file. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department.

The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/(800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

Report continues on 809-C.

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Seychelle De Luca	TELEPHONE: (916) 217-4316
LICENSING EVALUATOR SIGNATURE:	DATE: 05/13/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2020

LIC809 (FAS) - (06/04)

Page: 2 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: SACRAMENTO MONTESSORI SCHOOL	FACILITY NUMBER: 343623561
	VISIT DATE: 05/13/2020

NARRATIVE

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AS discussed the following: 100% supervision is required at all times; personal rights; inspection authority; reporting requirements; staff to children ratios and capacity; staff qualifications; and maintaining buildings and grounds. AS discussed with Applicants any changes that may occur regarding the director or an employee acting in the director's absence must be reported to department within 10 working days.

Applicants were encouraged to the visit the Department's website at WWW.CDSS.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining to child care centers.

This facility evaluation report was reviewed and discussed with Applicants. AS emailed a copy of the 809 to Applicants. Applicants understand they must read the reports and send back an acknowledgement that they read and received the report. AS also emailed LIC311A, Effects of Lead Exposure brochure, Healthy Schools Act survey, and immunization card.

CONDITIONS REQUIRING CORRECTION PRIOR TO ISSUING A LICENSE:
1. Fire clearance
2. Proof two more potty chairs are available.
3. Proof the fence separating the preschool and infant yard is completely put installed.
4. Licensing Program Manager (LPM) Engelman's final approval about infant napping mats.
5. Submit a waiver request for insufficient outdoor space with the acknowledgement that no more than 38 infants and toddlers may use the outdoor space at one time. The request will include schedules of when the different groups will go outside.

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Seychelle De Luca	TELEPHONE: (916) 217-4316
LICENSING EVALUATOR SIGNATURE:	DATE: 05/13/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2020

LIC809 (FAS) - (06/04)

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